Metabolic-associated fatty liver disease (MASLD) affects more than a third of the world's population and is considered the most common chronic liver disease. A new study from Keck Medicine of USC, published in Clinical Gastroenterology and Hepatology, identified three key factors that most significantly increase the risk of death in patients with MASLD: high blood pressure (by 39 percent), impaired glucose tolerance (by 26 percent), and low levels of “good” HDL cholesterol (by 15 percent).
MASLD is when too much fat builds up in liver cells, not because of alcohol, but because of a metabolic problem. Think of your liver as a filter that's become clogged with fat. Research has shown that three things are most dangerous for people with this problem:
1) high blood pressure, which forces the heart and blood vessels to work harder;
2) a condition close to diabetes, when the body does not properly absorb sugar from food;
3) lack of “good” cholesterol, which acts as a “garbage collector” that cleans harmful fats from the blood.
The analysis of nearly 21,000 patients from the NHANES database showed that the risks of these factors persisted regardless of gender, age and ethnicity. Particularly surprising was that hypertension was associated with a higher risk of death than diabetes, which changes the approach to treatment priorities.
That is, it does not matter who you are – male or female, young or old – these three factors are equally dangerous for everyone. The biggest surprise for scientists is that high blood pressure turned out to be even more threatening than diabetes. Previously, doctors considered diabetes the main “villain” in this story, but now they understand that controlling blood pressure in such patients is perhaps the number one task for saving lives.
The researchers also noted that the higher the body mass index, the higher the likelihood of adverse outcomes. In addition, the risk of mortality in patients with MASLD increases by 15 percent with each additional cardiometabolic factor.
Body mass index (BMI) is a simple measure that relates your weight to your height. In short, the more overweight a person is, the worse their disease can be. And most importantly, these problems accumulate. If you have just one of them, for example, high blood pressure, that's already a risk. But if you also have low “good” cholesterol, your risk of death increases by 15%. And if you have all three factors, they work together to significantly worsen the prognosis.
According to the authors, the results will help doctors more accurately identify groups of patients at greatest risk and develop more effective treatment strategies.
This study is like a new, more accurate map for doctors. Now they know which “red flags” to look for first. This will allow them to focus their efforts on patients who are at greatest risk and tailor their treatment to address their weakest areas, such as blood pressure control.
This article is for informational purposes only and is not a substitute for professional medical advice.
